Validation of a modified scoring system for cardiovascular risk associated with major lung resection

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Mark FergusonWickii T Vigneswaran

Abstract

The well-known revised cardiac risk index (RCRI) has recently been modified based on factors and outcomes specific to thoracic surgery patients (ThRCRI). We explored the accuracy of this modified scoring system in predicting cardiovascular morbidity after major lung resection. We analyzed outcomes from a prospective database of patients undergoing major lung resection 1980-2009. ThRCRI score was based on weighted factors for serum creatinine, coronary artery disease, cerebrovascular disease and extent of lung resection. Target adverse outcomes included pulmonary embolism, myocardial infarction, cardiac arrest, pulmonary edema and cardiac death. A total of 1255 patients (mean age 61.8 years; 649 men) underwent lobectomy or bilobectomy (1070; 85%) or pneumonectomy (185; 15%) for cancer (1037; 83%) or other problems. Severe cardiovascular complications occurred in 30 patients (2.4%), an incidence similar to that in the published derivation group (3.3%). ThRCRI median scores in patients without and with severe CV complications were 0 and 1.5 (P < 0.001). Score categories yielded incremental risks of cardiovascular complications (0: 0.9%; 1-1.5: 4.5%; ≥ 2: 12.8%; P < 0.001). The Hosmer-Lemeshow test demonstrated no significant diffe...Continue Reading

References

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Citations

Jan 14, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Pierre-Emmanuel Falcoz
Feb 12, 2013·Interactive Cardiovascular and Thoracic Surgery·Miguel GuerraJosé Miranda
Dec 3, 2013·Journal of Cardiothoracic Surgery·Robin WottonKhalid Hussain
Oct 6, 2014·The Annals of Thoracic Surgery·Mark K FergusonAlex Brunelli
Jun 7, 2014·Expert Review of Respiratory Medicine·Joanna Sesti, Jessica S Donington
Apr 4, 2014·The Annals of Thoracic Surgery·Terry Shih
Feb 26, 2014·The Annals of Thoracic Surgery·Mark K FergusonAlex Brunelli
Aug 13, 2013·Thoracic Surgery Clinics·Sabha Ganai, Mark K Ferguson
May 26, 2015·The Annals of Thoracic Surgery·Alessandro BrunelliGonzalo Varela
Feb 26, 2014·Brazilian Journal of Anesthesiology·Luiza Helena Degani-CostaLuiz Fernando dos Reis Falcão
Aug 23, 2016·Clinical Oncology : a Journal of the Royal College of Radiologists·C HarrisR C Rintoul
Oct 13, 2016·Current Surgery Reports·Michele Salati, Alessandro Brunelli
Feb 20, 2015·Anesthesia and Analgesia·Bruce Biccard
Sep 5, 2020·Surgical Oncology Clinics of North America·Alessandro BrunelliCecilia Pompili
Mar 29, 2021·Anaesthesia Critical Care & Pain Medicine·Hany Hasan Elsayed, Assem Adel Moharram

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